What is cholesterol?
Cholesterol is a fatty substance in our blood, which is produced naturally in the liver. Everyone has cholesterol. We need it to stay healthy because every cell in our body uses it. Some of this cholesterol comes from the food that we eat.
There are different types of cholesterol and they mean different things for your health. Cholesterol is carried in your blood by proteins. When cholesterol and proteins combine, they’re called lipoproteins.
Total cholesterol
Your total cholesterol is your “good” HDL cholesterol and your “bad” non-HDL cholesterol together. For a healthy heart, the aim is to have
a low non-HDL level and a higher HDL level.
High-density lipoproteins / HDL cholesterol (Good)
HDL takes cholesterol that you don’t need back to the liver where it is broken down to be passed out of your body. This is known as ‘good’ cholesterol because it gets rid of ‘bad’ cholesterol from your blood vessels.
Non-High-density lipoproteins / Non-HDL cholesterol (Bad)
It delivers cholesterol from the liver to cells around your body. This is known as ‘bad’ cholesterol because if you have too much it gets stuck
to the walls of your arteries.
What are Non-HDL cholesterol?
These are other types of bad cholesterol in the blood.
What are Triglycerides?
These are another kind of fat which is found in your blood system this is produced naturally in your body by your liver. These fats are also found in our foods such as meat, dairy produce, and cooking oils.
What do we mean by High Cholesterol?
If you have more bad cholesterol in your blood than you need, it gets stuck to the walls of the arteries. This makes it harder for blood to flow through, which can cause a heart attack or stroke.
If your total cholesterol is high, it can mean you have a lot of bad (Non-HDL) cholesterol in your blood. A high level of good (HDL) cholesterol can help keep that bad (Non-HDL) cholesterol in check and remove it from your body. You will need to have a blood test to advise you of your levels. A heathy level of total cholesterol is 5 or below.
What causes high cholesterol?
High cholesterol can be caused by
- Eating a lot of saturated or trans fats
Smoking
Not being active enough
Having too much body fat, especially around your middle
Things you cannot do anything about
- Getting older
Ethnic background
Family History
How can you reduce your cholesterol levels?
You can reduce your chances of a condition like heart attack or stroke. Eating a healthy diet and doing regular exercise can help lower the level of cholesterol in your blood. Adopting healthy habits, such as eating a healthy, balanced diet and keeping active, can also help prevent your cholesterol levels becoming high in the first place. Here are some of the ways you can help your cholesterol get back to a healthy level:
Diet
Fats
There are 2 main types of fat: saturated and unsaturated. Eating too many foods high in saturated fat can raise the level of cholesterol in your blood. Most people in the UK eat too much saturated fat.
Foods high in saturated fat (bad fat)
meat pies
sausages and fatty cuts of meat
butter, ghee and lard
cream
hard cheeses
cakes and biscuits
foods containing coconut or palm oil
Foods high in unsaturated fat (good fat)
oily fish – such as mackerel and salmon
nuts – such as almonds and cashews
seeds – such as sunflower and pumpkin seeds
avocados
vegetable oils and spreads – such as rapeseed or vegetable oil, sunflower, olive, corn and walnut oils
Trans fats
Trans fats can also raise cholesterol levels. Trans fats can be found naturally in small amounts in some foods, such as animal products, including meat, milk and dairy foods. Artificial trans fats can be found in hydrogenated fat, so some processed foods, such as biscuits and cakes, can contain trans fats. In the UK, manufacturers and most of the supermarkets have reduced the amount of trans fats in their products. Most people in the UK do not eat a lot of trans fats, but you should keep checking food labels for hydrogenated fats or oils.
Reducing total fat
Reducing the total amount of fat in your diet can also help reduce your risk of heart disease. Instead of roasting or frying, consider:
grilling
steaming
poaching
boiling
microwaving
Choose lean cuts of meat and go for lower-fat varieties of dairy products and spreads, or eat a smaller amount of full-fat varieties.
Fibre and cholesterol
Eating plenty of fibre helps lower your risk of heart disease, and some high-fibre foods can help lower your cholesterol. Adults should aim for at least 30g of fibre a day.
Foods high in fibre
wholemeal bread, bran and wholegrain cereals
fruit and vegetables
potatoes with their skins on
oats and barley
pulses, such as beans, peas and lentils
nuts and seeds
Foods high in cholesterol
Some foods naturally contain cholesterol, called dietary cholesterol. Foods such as kidneys, eggs and prawns are higher in dietary cholesterol than other foods. Dietary cholesterol has much less of an effect on the level of cholesterol in your blood than the amount of saturated fat you eat does.
If your GP has advised you to change your diet to reduce your blood cholesterol, the most important thing to do is to cut down on saturated fat. It’s also a good idea to increase your intake of fruit, vegetables and fibre.
Get active
An active lifestyle can also help lower your cholesterol level. Activities can range from walking and cycling to more vigorous exercise, such as running and energetic dancing.
Doing 150 minutes of moderate aerobic activity every week can improve your cholesterol levels.
Moderate aerobic activity means you’re working hard enough to raise your heart rate and break a sweat.
One way to tell whether you’re exercising at a moderate intensity is if you can still talk but cannot sing the words to a song.
Read more about getting more active and achieving your recommended activity levels.
Cholesterol-lowering products
If your doctor has told you that you have high cholesterol and you can lower it by changing your diet, there’s no need to buy special products to lower your cholesterol.
These products are not recommended by doctors and are no substitute for a healthy, balanced diet.
There are foods specially designed to lower your cholesterol, such as certain dairy spreads and yoghurts containing added ingredients called plant sterols and stanols.
There’s some evidence these ingredients may help reduce the cholesterol in your blood, but there’s no evidence they also reduce your risk of a heart attack or stroke.
These products are designed for people who already have high cholesterol, but it’s not essential to eat plant sterols or stanols to help manage your cholesterol.
There may be other, simpler and less expensive changes you can make, such as eating a healthy, balanced diet and being more physically active.
There are some groups of people these products are not suitable for, including children and pregnant or breastfeeding women.
If you do eat foods designed to lower your cholesterol, read the label carefully. These foods need to be eaten every day and in the right amount, as having too much could be harmful.
Medications
Statins
Statins are medicines that can help lower the level of LDL (bad) cholesterol in yourn blood. They’re usually offered to people who have been diagnosed with coronary heart disease or another cardiovascular disease, or whose personal or family medical history suggests they’re likely to develop it during the next 10 years.
For most other people, the first way to tackle high cholesterol is by making changes to your diet and getting more active.
People who need statins can be prescribed them, and your GP can also advise you on healthy lifestyle changes.
Ezetimibe
If a statin medicine does not work for you, you may be prescribed ezetimibe. This medication helps stop your body taking in cholesterol from food. It usually lowers cholesterol levels within 2 weeks. Treatment with ezetimibe is usually for life.